A 10-year-old NM DSH was presented for evaluation of a grade 4/6 heart murmur. Systolic blood pressure was elevated (160).
A 10-year-old NM DSH was presented for evaluation of a grade 4/6 heart murmur. Systolic blood pressure was elevated (160).
A 10-year-old NM DSH was presented for evaluation of a grade 4/6 heart murmur. Systolic blood pressure was elevated (160).
A 10-year-old NM DSH was presented for evaluation of a grade 4/6 heart murmur. Systolic blood pressure was elevated (160).
This is a case of hypertrophic obstructive cardiomyopathy (HOCM). The heart murmur is certainly caused by SAM. There doesnВґt exist any evidence for the treatment of such asymptomatic patients. Because auf the mild increase in left atrial dimensions, the high heart rate (190/min) and the SAM I would try Atenolol at a dosage of 6.25 mg/cat s.i.d. But because studies are still lacking I cannot say whether this has an influence on the progression of the disease. It usually reduces the dynamic obstruction. I would do a follow up after 9-12 months.
I see clearly segmental concentric hypertrophy of the basal interventricular septum. The rest of the left ventricle appears normal, no endocardial fibrosis or excessive moderator bands visible. The left atrium is slightly enlarged. Systolic anterior motion of the anterior mitral valve leaflet is clearly seen. The aortic valve is fluttering during systole as a consequence of turbulence within the LVOT. Flow across the LVOT obtained by spectral Doppler shows some endsystolic acceleration because of dynamic obstruction. The right ventricle and atrium appear to be normal, no turbulence or flow acceleration within the RVOT. Echotexture and echogenicity of the myocardium are normal. ThereВґs no tumor visible. No pericardial effusion.
Dilated/hypertrophic cardiomyopathy, vegetative endocarditis, mitral/tricuspid endocardiosis, ventricular hypertrophy secondary to hypertension, anemia
None